Active NPI
Anna Ezrine
- Behavior Technician
- Marietta, GA
National Provider Identifier
1205487808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 376 Powder Springs St Ste 140
Marietta, GA 30064-3448 - Phone
- (678) 691-2206
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
376 Powder Springs St Ste 140
Marietta, GA 30064-3448
Mailing address
235 Pharr Rd NE Apt 1405
Atlanta, GA 30305-2441
Other practice location 1
6849 Peachtree Dunwoody Rd Bldg A1
Sandy Springs, GA 30328-6769
Phone (678) 691-2206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1205487808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 PHARR RD NE APT 1405",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303052441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "376 POWDER SPRINGS ST STE 140",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300643448",
"telephone_number": "678-691-2206"
}
],
"practiceLocations": [
{
"address_1": "6849 Peachtree Dunwoody Rd Bldg A1",
"address_purpose": "LOCATION",
"city": "Sandy Springs",
"state": "GA",
"postal_code": "303286769",
"country_code": "US",
"telephone_number": "678-691-2206",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EZRINE",
"first_name": "ANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.